Conducting pharmacoepidemiologic research requires knowledge of pharmacology, geriatric medicine and epidemiology. Dr. Ronald Shorr is a board certified internist and geriatrician who has research experience in pharmacology and pharmacoepidemiology. He has recently completed a M.S. in epidemiology and was chosen as the first Ciba-Geigy Fellow in Pharmacoepidemiology at Vanderbilt. The proposed NIA Academic Award will provide five additional years of protected research with established investigators in this field. Dr. Shorr will spend most of the first two years of the proposed NIA Academic Award conducting a population-based retrospective cohort study of individual sulfonylureas and the risk of serious hypoglycemia in elderly persons using the Tennessee Medicaid database. He will develop an awareness of the strengths and limitations of automated databases for pharmacoepidemiologic research, and will acquire the skills necessary to conduct future investigations independently. Dr. Shorr will also participate in a study of an educational intervention to reduce antipsychotic drug use in long term care settings. This field research in long term care will compliment the database investigation and give Dr. Shorr an opportunity to function as a clinical collaborator in an ongoing large-scale investigation. The final three years of the proposed Academic Award will be spent on further database and/or field projects. A potential project is the investigation of hemorrhagic complications of oral anticoagulants in elderly persons using the Medicaid or other automated database. It is anticipated that this focused research experience will enable him to conduct independent investigations in this vitally important discipline. Dr. Shorr will also have an appointment in the Department of Internal Medicine at Vanderbilt. He will join two other geriatricians to form the nucleus of a growing clinical program. As such, he will have the opportunity to teach geriatric medicine to medical students and house staff in both inpatient and ambulatory settings. He will also play a role in curriculum development as preclinical and clinical teaching of geriatrics at Vanderbilt continues to expand. These activities will augment the research program in the Department of Preventive Medicine towards the preparation of Dr. Shorr for a future leadership role in geriatric medicine.